Restorative Dentistry

Restorative dental treatment involves the removal of dental caries and the restoration of cavities or structural defects caused by fractures or material loss by filling the prepared cavity with an artificial restorative material.

Dental Caries

Dental caries is defined as a disease of the dental hard tissues that develops as a result of multiple interacting factors. The main etiological factors of dental caries include:

Etiological Factors of Dental Caries:

·         Dental plaque

·         Microorganisms

·         Individual factors (tooth structure, salivary composition, genetic predisposition, etc.)

·         Carbohydrate-rich foods (sugars, refined flour, etc.)

·         Time (duration of food retention in the oral cavity)

How Do Teeth Develop Caries?

Bacterial plaque formed in the oral cavity can metabolize residual sugars and carbohydrates, producing acids. These acids dissolve the mineral structure of the tooth, leading to demineralization of the enamel and resulting in tissue loss known as dental caries.

Dental caries may occur on the occlusal surfaces, interproximal contact areas, or cervical regions near the gingiva. Caries on visible surfaces, presenting as discoloration or cavitation, are relatively easy to detect. However, hidden interproximal caries may remain unnoticed for long periods and often require radiographic examination for diagnosis.

If caries initiating in the enamel is left untreated, it progresses into the dentin, which is more susceptible to acid dissolution. As a result, caries advances more rapidly at this stage. When dentin is involved, sensitivity to hot, cold, or sweet stimuli may occur and typically resolves once the stimulus is removed. At this stage, treatment usually requires a larger restoration. However, if pain becomes persistent, the carious lesion has likely reached the pulp chamber, necessitating root canal treatment.

 Composite Restorations

Composite resin is a plastic-based material containing silicon dioxide particles. Due to its wide range of shades, it closely mimics natural tooth color and is therefore also referred to as an aesthetic or tooth-colored filling. Initially used primarily for anterior teeth, advancements in material technology have made composites suitable for posterior teeth as well. The material is bonded to the tooth using a special adhesive system and polymerized with a light-curing device. Finishing and polishing are completed in the same appointment.

Composite Laminate Veneers (Bonding)

Bonding is used to repair fractures and cracks or to modify the shape and color of teeth, particularly in the anterior region. First, the shade of the composite material is matched to the natural tooth color. The tooth surface is then mildly etched to create micro-retention, followed by the application of a bonding agent to ensure strong adhesion. After placement, the composite material is shaped and hardened using a high-intensity curing light, and finally polished to achieve a natural appearance. Bonding is most effective for small restorations, as larger areas may be more prone to fracture.

Porcelain Inlays and Onlays

In cases of extensive tooth structure loss where conventional fillings are insufficient yet full-coverage crowns would be overly invasive, porcelain inlays and onlays provide an optimal restorative solution. These restorations are custom-fabricated in a dental laboratory using porcelain or composite materials to restore only the damaged portion of the tooth.

This approach preserves maximum healthy tooth structure while offering superior strength and esthetics compared to traditional fillings. In endodontically treated teeth with reduced structural support, endocrown designs utilize the pulp chamber for retention without excessive reduction of surrounding tooth tissues. Manufactured using digital scanning technologies with micron-level precision, these porcelain restorations support periodontal health and optimally distribute occlusal forces. Modern restorative techniques ensure the preservation of natural tooth form and long-term functional durability.

Porcelain Laminate Veneers

The anterior surfaces of the teeth are minimally prepared by reducing approximately 0.5 mm of enamel. Impressions are taken, and the porcelain veneers are fabricated by a dental technician. These restorations are extremely thin—similar to the thickness of a fingernail—and resemble shells that are bonded onto the natural tooth surface.

Due to their translucency and color stability, porcelain laminate veneers provide a highly natural appearance that harmonizes with the tooth’s shape, size, color, and length. They are commonly used to correct discoloration, wear, minor misalignment, and aesthetic irregularities.

What is Porcelain Laminate Veneer Treatment?

Porcelain laminate veneers, also known as “porcelain laminates” or “veneers,” are ultra-thin porcelain restorations. This treatment involves bonding a custom-made porcelain layer, prepared in the desired color, size, and shape, to the front surface of the tooth.

For this procedure, minimal preparation is required—approximately 0.5 mm reduction from the front surface of the tooth. In some cases, the treatment can be performed without any tooth reduction.

During the initial examination, impressions are taken before any tooth preparation. Based on these impressions, a wax-up model is prepared in the laboratory. At the scheduled appointment, this model can be tried in the patient’s mouth to demonstrate the final appearance of the teeth. This allows both the dentist and the patient to evaluate the planned outcome and reach a mutual agreement.

After obtaining the patient’s approval, final impressions are taken and sent to the laboratory. Once the veneers prepared in the laboratory are tried in clinically, the final form is approved, and the porcelain laminate veneers are bonded to the teeth, completing the treatment.

What are the advantages of Porcelain Laminate Veneers?

Porcelain does not undergo color changes over time due to its material properties.

Since very little tooth structure is removed, a significantly greater amount of natural tooth tissue can be preserved compared to other restorative options.

How long does Porcelain Laminate Veneer treatment take?

The preparation phase generally takes approximately 7–10 days.

If gingival (gum) adjustments are required, this period may be extended.

After tooth preparation is completed, the veneers are usually delivered within another 7–10 days.

Is Porcelain Laminate Veneer treatment painful?

Because the enamel layer on the front surface of the tooth is reduced, mild sensitivity to hot and cold may be experienced. After tooth preparation, rough surfaces may be felt with the tongue.

To prevent discomfort and aesthetic concerns during the waiting period, temporary restorations are prepared and placed after tooth preparation.

How long do porcelain laminate veneers last?

If the patient maintains good oral hygiene and attends regular check-ups every six months, no significant problems are expected.

The lifespan may vary depending on usage and individual habits; veneers may last 20–30 years, while in some cases issues may occur within 5–6 years.

Full Porcelain Crowns

Full porcelain crowns are made of reinforced porcelain that transmits light at varying degrees, making them one of the closest alternatives to natural teeth in terms of translucency.

They bond to the tooth both mechanically and chemically.

Due to their composition, full porcelain crowns are biocompatible and gentle on the gums.

Zirconium Crowns

Zirconia crowns, with their high fracture resistance and strength, can be successfully used in both anterior and posterior regions.

The white-colored substructure of zirconia ceramics eliminates aesthetic concerns associated with metal frameworks.

This makes it possible to achieve crowns that are both highly aesthetic and durable.

Which is the Best Type of Filling?

There is no single filling material suitable for everyone.

The most appropriate filling type is determined based on the size of the cavity, any existing allergies to certain materials, and the location of the tooth to be restored.

How Can Dental Caries Be Prevented?

The first step is to visit the dentist every six months for regular check-ups and to follow professional recommendations.

Food debris and acids produced by dental plaque can sometimes be neutralized by saliva alone. For this reason, chewing sugar-free gum to stimulate saliva flow can be beneficial. Adequate and fluid saliva has sufficient buffering capacity and a cleansing effect within the oral cavity, helping to remove food debris and dissolve sugars.

However, saliva alone is often insufficient to combat dental caries, especially in cases of rapidly progressing decay.

The most effective way to prevent cavities is regular toothbrushing and flossing. Toothbrushing plays a major role in mechanically removing plaque. Brushing the tongue also helps eliminate food residues.

Interdental cleaning can be effectively achieved through the use of dental floss.

In cases where the enamel is weakened but cavities have not yet formed, fluoride applications can strengthen the enamel again through remineralization.

If your dentist determines that you have an increased risk of developing caries, they may recommend personalized toothpaste and mouth rinses to help reduce this risk.